- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $2,818.38 / $5,128.61
| Facility | | $275.42 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $275.42 / $645.65
| Professional | | $151.36 | $275.42 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $3,162.28 / $28,840.32
| Facility | | $389.05 | $3,162.28 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $354.81 / $933.25
| Professional | | $177.83 | $354.81 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $457.09
| Facility | | $194.98 | $194.98 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $426.58 / $831.76
| Professional | | $208.93 | $426.58 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $354.81 / $691.83
| Professional | | $186.21 | $354.81 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $501.19 / $7,079.46
| Facility | | $165.96 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $467.74 / $630.96
| Professional | | $380.19 | $467.74 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $389.05 / $831.76
| Professional | | $190.55 | $389.05 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $3,162.28 / $28,840.32
| Facility | | $389.05 | $3,162.28 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $354.81 / $933.25
| Professional | | $177.83 | $354.81 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $363.08 / $794.33
| Professional | | $190.55 | $363.08 | $794.33 |